Would you recommend your HRT?

I am curgently on Kliovance which my GP said was fine despite me still having periods. It is continuous and supposed to make periods stop (Notheristerone) but I have had daily spotting since starting on it over 2 months ago and constantly feel like I'm about to start a period Plus my libido has plummeted.

Prior to this I was on Fermosten for a few months but wanted to swap as I was feeling really grumpy and my periods /PMT were getting worse.

And I had swapped to that from Prempack C which I had been on successfully for about 5 years as I wanted to try a lower dose and GP agreed.

I am thinking of asking to go back to Prempack, but maybe there is another one I could try?

I think finding the best type depends on your priorities. For me, it's safety and reducing the risks. I've used it for 8 years and been told I can carry on (unless reasons not to occur.)

I use Oestrogel which is great because you can alter the dose to suit needs. I use micronised progesterone (Utrogestan) for 10-12 days every few weeks (have avoided a 4-week monthly cycle because I didn't want bleeds every month in my 60s) but this is under the guidance of a consultant.

My own preferences are:I want bio identical hormones ( so that rules out Prempack as it's conjugated oestrogen)I don't want pills because they are linked to a higher risk of blood clots.Don't want patches as they are unsightly (imo)Don't want synthetic progestogens taken daily are linked to the highest risk of breast cancer. (All the research is leading this way - dydrogesterone seems safest of the synthetics, medroxyprogesterone the least safe) )Don't want the Mirena for same reason.

I tried continuous Utrogestan but I got headaches and spotting daily for 3 weeks and decided it wasn't for me.

They do say give all conti types 6 months for the bleeding to settle so you could carry on a bit longer?

I'm not sure about this but I suspect your GP is not allowed to 'ration' the types of HRT they prescribe. I don't know where they are coming from with the 'can't prescribe patches or gel' but I suspect it's unethical.

If it's on the basis of cost, this is not right. I'd query it and if necessary ask the practice manager or someone else.

I think the line to take with your GP is that she doesn't know much about HRT( has she said this to you? If not be tactful!) so you'd like a referral having tried 3 types and not really got on with them.

Gel is suitable at any age. I started with it around the same age as you. Transdermal (gel/ patches) is recommended for all women as they get older because it's safer re. blood clots (this is in the NICE info on menopause) so if you wanted to stay on HRT long term, your GP would have to consider this anyway. That's why it doesn't make sense for her to say they 'don't offer it' because one day there will be a woman who needs it due to age or medical risks.

There is usually a list of products different health areas will allow you to prescribe but these should include patches and I think gels too. Where I am we can email for advice when we get "stuck" with menopause problems. I'm on evorel Conti and it's changed my life. Only been on 5 weeks.

I'm 50 and perimenopausal, I've had a Mirena IUS for just over two years and this provides my progesterone (originally just as a contraceptive). I've been using Oestrogel for 8 months now and I'm very happy with it.

I started on the minimum dose but have upped that for the last few months (GP aware) as I was starting to really struggle with mood/anxiety issues and the increase in oestrogen has helped.